kidney disease in dogs loss of appetite

Chronic Kidney Disease (CKD) in Dogs

What Is Chronic Kidney Disease (CKD) in Dogs?

Dogs have two kidneys, which are vital for maintaining lifes day-to-day processes. They have a variety of functions, the foremost of which is to filter and excrete toxins and waste from the body. Other tasks of the kidneys include regulating fluid, mineral, and electrolyte balance; conserving water and protein; maintaining blood pressure; and producing red blood cells.

Many causes are associated with progressive loss of kidney function, and unfortunately, once lost the damage is irreversible. As a result, unfiltered waste products and toxins build up in the bloodstream, leading to a generalized state of nausea and malaise. When left untreated or unmanaged, a dogs quality of life suffers. Early diagnosis and intervention are vital to managing the disease and maintaining your dogs comfort and well-being.

CKD is a progressive disease that has often been present for some time before it is diagnosed. It is typically classified into four stages, based on laboratory values and clinical signs:

• Stage I: No clinical signs are seen.

• Stage II: Some clinical signs are seen.

• Stage III: Many clinical signs are seen, and pets often feel sick.

• Stage IV: The majority of clinical signs are seen, often as an emergency. The quality of life for the pet is poor.

Is Chronic Renal Failure the Same Thing as Chronic Kidney Disease?

Chronic kidney disease (CKD), renal insufficiency, and chronic renal failure (CRF) are different terms often used interchangeably to describe declining kidney healthwhere over time the kidneys become less efficient in their required tasks and the results are life-threatening.

Symptoms of CKD in Dogs

Dogs typically wont experience any symptoms until the kidneys have lost about 75% of their functioning capacity. The higher the stage (meaning the greater the extent of kidney disease present), the more symptoms are exhibited.

Dogs in any stage can experience the following symptoms:

• Anemia (low red blood cell count)

• Changes in urine output, usually increased

• Decreased appetite

• Dehydration

• Increased thirst

• Muscle wasting

• Nausea

• Oral ulcerations (sores in the mouth) and bad breath

• Pale gums

• Poor coat appearance

• Sporadic vomiting

• Vision loss, often attributed to secondary hypertension (high blood pressure)

• Weakness and lethargy

• Weight loss

Causes of CKD in Dogs

Chronic renal failure by definition is a disease that occurs over a period of time; it is an ongoing, progressive, and irreversible process where, for some dogs, the cause remains unknown despite extensive testing.

Often CKD develops after a serious kidney injury such as from a severe infection (e.g., leptospirosis, tick-borne disease, or pyelonephritis), heat stroke, envenomation (from a venomous bite or sting), or the ingestion of toxic substances like antifreeze, NSAIDs (ibuprofen), or certain antibiotics. CKD is also associated with certain types of immune-mediated diseases or cancer.

Dogs breeds commonly prone to CKD include:

How Veterinarians Diagnose CKD in Dogs

A veterinarian will start with a physical exam, bloodwork, and a urinalysis to look specifically at kidney values such as:

• Blood urea nitrogen (BUN): higher values correlated with kidney failure

• Calcium

• Creatinine (CREA): indicator of the kidneys ability to filter wastes from blood

• Electrolytes: sodium, potassium, chloride

• Phosphorous: higher phosphorus levels seen with CKD

• Red blood cell count: low red blood cell counts are often seen secondary to CKD

• Symmetric dimethylarginine (SDMA): an indicator used for early detection of kidney disease

• Urine specific gravity:determines the kidneys concentrating ability; the more concentrated the urine is, the greater the ability of the kidneys to conserve water

Your veterinarian may also recommend additional testing such as:

• A urine protein to creatinine (UPC) ratio to determine how much protein is lost in the urine (termed proteinuria)

• A urine culture, as dogs with CKD are more likely to acquire urinary tract infections

• A blood pressure evaluation, as dogs with CKD often have hypertension (high blood pressure)

• Radiographs or abdominal ultrasound to screen for kidney stones, tumors, or infarcts (areas of dead tissue)

Treatment of CKD in Dogs

CKD is a manageable but incurable diseasesince by the time dog is symptomatic, irreversible damage has already occurred. Recommendations based on the stage of CKD will be tailored to match your dogs needs, with dogs in Stage III or IV warranting greater care and therapy than dogs in Stage I or II. Common therapies for CKD include medications, diet, and fluid therapy, along with treatment for any underlying condition or inciting factors.

Medications such as Cerenia, ondansetron, or omeprazole can help aid nausea, vomiting, and lack or loss of appetite. For some dogs with more extensive needs, a feeding tube may be placed. Additionally, appetite stimulants such as capromorelin and mirtazapine may be recommended.

Most vets will prescribe dietary management with a balanced diet that is lower in protein, salt, and phosphorus and is alkalinized to help combat side effects associated with CKD. Recommended diets typically include:

Fluid therapy is essential. Fluids will flush out toxic waste substances that the kidneys should be doing on a routine basis and restore hydration. They can be given intravenously in the hospital or subcutaneously (underneath the skin) at home. Your dog should have access to fresh water at all timesa water fountain can be an especially important item to add to your home.

Recovery and Management of CKD in Dogs

CKD is a serious lifelong condition that requires ongoing care and monitoring as symptoms continue to develop. Dogs with CKD require more frequent veterinary visits and testing than others, and at all stages of CKD, quality of life should be assessed as symptoms change. Be sure to adhere to your veterinarians recheck guidelines and continue all medications and diet as recommended; many will be required for life.

Depending on the circumstances, certain measures can help keep your dog comfortable and offer a good quality of life for as long as possible. Similar treatment and medications to those outlined above also are applicable for long-term management of CKD in dogs, such as:

• Dietary supplements such as Azodyl, a pre/probiotic, that can help decrease waste products not eliminated by the kidneys.

• Other supplements, such as aluminum hydroxide and Epakitinare geared to aid with low potassium and high phosphorus.

• Anti-nausea and anti-emetic (anti-vomiting) medications can be prescribed as needed for dogs who experience intermittent vomiting and lack of appetite.

Unfortunately, given the severity of symptoms often experienced by dogs with Stage III or IV and the extensive amount of care and effort they require, euthanasia may be the best option.

Chronic Kidney Disease (CKD) in Dogs FAQs

How long can a dog live with kidney disease?

CKD is progressive; however, its difficult to anticipate the degree and timing of the progression. Some dogs can live for years with proper veterinary care and management, while others may have to be euthanized shortly after diagnosis.

How fast does kidney disease progress in dogs?

The progression of CKD in dogs varies, taking weeks to years for symptoms to be noticeable. Once known, though, it is estimated that 75% loss of kidney function has already occurred, and the damage is irreversible. Depending on the underlying cause, some dogs will deteriorate much faster than others. Frequent checkups and routine veterinary visits can help detect CKD sooner, which will ensure your dogs comfort and garner an overall better quality of life.

Featured Image: Adobe/Alan

WRITTEN BY

Michael Kearley, DVM

Veterinarian

Dr. Michael Kearley graduated from the University of Florida College of Veterinary Medicine in 2013. He graduated with a certificate in...

What to Feed a Dog with Kidney Disease Who Will Not Eat

Important Note: This article has been checked and verified by a professional veterinarian for accuracy. However, you should always seek advice from your own vet before making any decisions on euthanasia as thereare never black and white answers for this decision.

The term chronic kidney disease can be a terrifying phrase for many pet owners, who often assume that this means that the kidneys have stopped working completely. However, while the kidneys are not working to their full potential, they are still functional and can be encouraged to keep working with the help of medication and a controlled diet.

What to feed a dog with kidney failure who will not eat? Alongside any medication and dietary recommendations given to you by the vet, it is important that you make sure the food you are giving your dog is low in phosphorus and low in protein, both of which can cause the build up of waste matter in their system and can potentially worsen the condition of the kidneys.

Caring for a dog with kidney disease can seem like a tough task at first but knowing the important ins and outs on what to feed your dog and how can be important to maintaining their health and happiness.

What foods are good for dogs with kidney disease?

Fully functioning kidneys are used to remove excess phosphorus, proteins and sodium from the bloodstream, so with the onset of kidney disease these waste materials arent properly filtered and a higher level than normal in the bloodstream. Because of this, animals with kidney disease need food that does not contain large amounts of phosphorus, protein or sodium, so that stress can be taken off of the kidneys and allow them to perform their functions without any risk of further damage.

There are many different renal dog foods on the market, but it is always recommended to check the label to see how much of each of the reduced minerals and protein is in each meal. The NRC (National Research Council) recommend that no more than 22.25mg of phosphorus should be fed to your dog per day. They should also be fed a low percentage of protein, and the protein that isfed must be a really high-quality protein with high bioavailability. Alsoless than 1mg of sodium (usually found in salt) per Calorie.

With is reduction in their food, it is important that they are supplemented with omega-3 fatty acids from fish oil (NOT cod liver oil, as this is inflammatory). These fatty acids are very good for dogs, especially those suffering from heart disease, kidney disease, arthritis and many other long-term health conditions. When buying omega-3 tablets, check the manufacturers website or ask your vet if that particular brand is right for your dog to take.

Notes on feeding

While it is more common in older dogs, having your dog diagnosed with kidney disease doesnt mean the end of their life, and many animals with the diagnosis can continue to live happily for years afterwards. However, the bad news is that there is no way to repair the damage done to the kidneys, they dont regenerate like some organs like the liver can; but further damage can be prevented with a few relatively easy lifestyle changes.

Once you have the diagnosis from a vet, it is always recommended that you follow any instructions they have given you for medication or dietary requirements to the letter, as this can be vital to the health of your dog. This involves giving the prescribed medication exactly as instructed, as any changes in the dosage of medication can cause major issues.

• Feeding plan:Instead of giving your dog two large meals a day, it is better to feed them a few small meals spaced throughout the day, making sure the food is fresh every time. This can help if they do not have much of an appetite or are struggling with eating a large meal.
• Avoid treats:While your dog may like the occasional treat, try and avoid giving them too many extra snacks or scraps between meals. This is also generally recommended for most dogs, stopping them from putting on any excess weight that may negatively affect their health.
• Ensure plenty of fresh water:Kidney disease can often increase your dogs thirst, so make sure they always have access to clean, fresh water at all times, refilling their bowl when you notice it is getting a bit low. Because of this, feeding your dog moist or wet food can also help to quench their thirst.

Dog with renal disease refusing to eat

Loss of appetite is a very common symptom and side effect of kidney disease, but it important for your dogs health to make sure they are eating enough per day.

Dogs with kidney disease who refuse to eat are probably feeling nauseous. Changing up the food is an option, but it might be that they need to have some IV fluids at the vets to filter out the excess waste products which are causing the nausea, or they might need an anti-emetic to reduce the nausea.

If your dog is refusing to eat, or is continuing to eat a worryingly low amount of food, it is recommended that you speak to your vet first, just to make sure that there is no medical reason for this. They may also be able to offer some advice on how to encourage your dog to eat, as well as some kinds of food they may like.

Changing what kind of food you give your dog suddenly could be the reason for why they are not eating, so it is advised to transition them to a renal pet food over the course of a few days (again, on advice from your vet). If your dog doesnt like the taste of the food, you can try out different brands and flavours of renal dog food, or even add tasty low-sodium treats such as fish oil.

Some animals even like the change-up in foods, with their appetite changing per day. You wouldnt like to eat the same food every day, so make sure you have different options for food ready in case your dog turns its nose up at their usual food.

If your dog enjoys home-cooked food more than out-of-the-packet dog food, there are also many recipes to be found to cater to kidney disease, and it is essential that you make sure that the meal is well balanced and contains no more than the maximum limit of either phosphorus, sodium or protein. A board-certified animal nutritionist is often your best bet for finding suitable recipes, which can be found through your vets recommendations or through BalanceIT.coms recipe finder.

Enticing dog with kidney disease to eat

If your dog is still not eating, then assisted feeding may have to be done at first to encourage them. Never force your dog to eat, as this can stress them out, but through enticement and praise they can be persuaded and helped to regain their appetite.

As mentioned before, moist or wet food is best for dogs with increased thirst, rather than dry foods. Regardless, always make sure you dog has enough water in its bowl to quench itself.

If your dog is unused to a new type of dog food, try hand-feeding your dog small portions of food, warmed to just below body temperature. Over the few days you do this, they will become used to the new taste and be happy to eat out of their bowl. Small treats can also be used to keep them fed during bouts of poor appetite, but large amounts can be unhealthy.

In more extreme cases where an animal either refuses or cannot eat via traditional means, vets can use feeding tubes, which allows for liquid food and medication to be directly passed into the stomach through a syringe. This is best for animals who suffer from extreme stress during mealtimes, making their quality of life easier.

Related questions

Are carrots good for dogs with kidney disease?

All dogs love treats, and while giving them out too regularly can be an unhealthy thing especially for animals with renal disease, there are still options out there.

Strangely enough, giving your dog carrots to chew on is actually recommended, being good to chew while also being low in calories and high in vitamins and fibre. Carrots are also a great treat for dogs without kidney disease, not carrying the same risks of splintering or choking as with bones or rawhide. Green beans are also another great choice, although make sure they are fresh with no added salt to keep their sodium levels low.

If your dog enjoys certain human foods as treats, such as peanut butter, then some precautions may need to be taken. Peanut butter contains Vitamin E which is great for your dogs health; however, they also need to be checked for additives, with organic, low-sodium brands being available to give your dog.

When getting treats for your dog, is always advised that you check what foods dogs cannot eat before giving them other kinds of fruit or vegetables, as food like grapes are highly toxic to dogs and can actually trigger kidney failure. Do research and ask your vet for any advice on what not to feed your dog with kidney disease.

Are eggs good for dogs with kidney disease?

Eggs are a great source of protein for dogs, although raw eggs can cause biotin deficiency meaning that cooked eggs are best recommended for your dog to eat. However, for dogs with kidney disease, this protein can have a negative effect on their system; as well as the yolk, which contains high amounts of phosphorus.

Unless your vet tells you that an occasional egg is okay to feed your dog, it is best to avoid giving eggs to dogs with kidney disease, to stay on the safe side. A lot of dairy products, including milk, also contain large amounts of phosphorus and protein.

Every animal is different, with different preferences for food and how they eat, so experimenting with a picky animal can go a long way to figure out what your dog will like.

Dog will not eat prescription food

When your dog will not eat medication, hiding it in food is often the go-to way of getting them to take their pills. However, what happens if the medication is the food itself?

A sudden change of food can be a shock to a dog, especially if they have been eating the same thing every day for a long time now. If your vet permits it, perhaps mix together their old food into the new prescription food for a few days, before fully transitioning to the new prescription food entirely.

Sometimes their lack of appetite can simply be because of pickiness, which can be helped through tasty additions such as fish oil or meat broth as a topper with no stock added often the animal just needs to get used to the taste and will soon be happily eating it without any additional dressings. A positive attitude can also do wonders, with positive encouragement telling your dog that the food is good and nice to eat. Acting anxious or concerned about the food may give your dog reason to worry about the contents of the food.

Warm food is usually better than cold, but every animal has different tastes. If you dog turns its nose up at cold food, try warming it up to slightly above room temperature, or vice versa if they arent enjoying the warm food.

There may be other reasons for their loss of appetite, such as nausea, so if your dog isnt eating either its old or new food, your vet may be able to help treat any sickness or appetite loss. Medication-wise, along with feeding tubes, veterinarians can prescribe appetite-enhancing stimulants for animals that are not eating enough to properly fuel themselves to treat their underlying condition.

When looking for the right thing to feed your dog with kidney disease, it is always highly recommended that you consult your vet before taking any steps.

Handy Hint: I recently wrote a guide explaining what to do if your French Bulldog is not eating. Contains the signs to look out for, plus what you can do once they stop eating properly.

You might also like

Image in header via https://pixabay.com/photos/dog-sad-waiting-floor-sad-dog-pet-2785074/